Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cleaning Schedule

Which cleaning schedule are you requesting?

Monthly Trash Bin Cleaning (12x Cleaning Commitment)

Quarterly Trash Bin Cleaning (4x Cleaning Commitment)

Annual Trash Bin Cleaning (1x Cleaning Commitment)

Service Details

How many cans would you like to have cleaned?

One Bin ($60/Annually, $40/Quarterly, or $25/Monthly)

Two Bins ($90/Annually, $60/Quarterly, or $35/Monthly)

Three Bins ($120/Annually, $80/Quarterly, or $45/Monthly)

Four Bins ($150/Annually, $100/Quarterly, or $55 Monthly)

What day of the week does your trash usually run? (with the exception of holidays)

Monday

Tuesday

Wednesday

Thursday

Friday